Global Burden of Cardiovascular Diseases

In recent years, the dominance of chronic diseases as major contributors to total global mortality has emerged and has been previously described in detail elsewhere. By 2005, the total number of cardiovascular disease (CVD) deaths (mainly coronary heart disease, stroke, and rheumatic heart disease) had increased globally to 17.5 million from 14.4 million in 1990. Of these, 7.6 million were attributed to coronary heart disease and 5.7 million to stroke. More than 80 percent of the deaths occurred in low and middle income countries (WHO, 2009e).

Based on 2007 to 2010 data, 33% of US adults ≥ 20 years of age have hypertension. This represents ~ 78 million US adults with hypertension. The prevalence of hypertension is similar for men and women. African American adults have among the highest prevalence of hypertension (44%) in the world.

Checking blood pressure at home gives better control

Researchers in Finland have found that self-monitoring of blood pressure at home leads to better control over high blood pressure than does standard monitoring at the doctor’s office.

Over the years there has been disagreement amongst experts regarding the effectiveness of home monitoring, so Dr. Ilkka Kantola, from Turku University Hospital in Finland, and colleagues conducted a study involving 55 primary health care centers.

In the study a group of 113 patients measured blood pressure at home using an automated device twice daily for 7 days and then again at 2, 4, and 6 months, and the results were returned to the patients’ physicians.

A comparison group of 119 patients had blood pressure measured in their primary care providers’ offices at the same time periods.

The doctors in both groups were instructed to intensify treatment if the target blood pressure was not met.

It was found at the end of the study, that both groups experienced significant drops in blood pressure, but the effects were generally more pronounced in the home-monitoring group.

Kantola’s team also saw that significantly more patients in the home-monitoring group achieved their target blood pressure.

They do say that this may be at least partially related to more changes in blood pressure medications during the study, 85 changes in the home-monitoring group versus 73 in the comparison group.

But the investigators add that there remains however room for improvement since many of the patients failed to meet their target blood pressure.

Dr. Francesco P. Cappuccio, from Warwick Medical School in Coventry, UK, says in an accompanying editorial, that although the study suffers from various design limitations, its findings “highlight the potential role that self-monitoring of blood pressure can play in helping improve the management of high blood pressure in the community.

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